KEN STARR MD WELLNESS GROUP (NPI# 1598195810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598195810 |
Entity Type | Organization |
Organization Name | KEN STARR MD WELLNESS GROUP |
Practice Address |
107 Nelson St Arroyo Grande CA 93420-3318 |
Mailing Address |
107 Nelson St Arroyo Grande CA 93420 |
Practice Telephone | 6267979977 |
Practice Fax Number | 6268442977 |
Mailing Telephone | 6267979977 |
Mailing Fax Number | 6268442977 |
Enumeration Date | 2013-11-22 |
Last Update Date | 2017-07-19 |
Authorized Official Name | KEN STARR (OWNER) |
Authorized Official Telephone | 6267979977 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Street Address |
107 NELSON ST |
City | ARROYO GRANDE |
State | CA |
Zip Code | 93420-3318 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861431595 | Kenneth Starr | Emergency Medicine | 107 Nelson St, Arroyo Grande, CA 93420-3318 | 2006-06-06 |
1083153829 | Kristen Robin Anderson | Counselor | 107 Nelson St, Arroyo Grande, CA 93420-3318 | 2017-02-13 |
1871048769 | Tikva Treatment | Substance Abuse Rehabilitation Facility | 107 Nelson St, Arroyo Grande, CA 93420-3318 | 2016-08-20 |
1659715100 | Elaine Shaver Power | Marriage & Family Therapist | 107 Nelson St, Arroyo Grande, CA 93420 | 2013-04-25 |
1629117981 | Emily Jean Maddox | Counselor | 107 Nelson St, Arroyo Grande, CA 93420-3318 | 2007-02-05 |
1982789186 | Kenneth Scott Guess | Pharmacist | 107 Nelson St, Arroyo Grande, CA 93420-3318 | 2006-10-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992337174 | Element Nutrition Company, LLC | Dietitian, Registered | 405 E. Branch St. #102, Arroyo Grande, CA 93420 | 2020-02-06 |
1861965055 | Pacific Central Coast Health Centers | Clinic/Center | 850 Fair Oaks Ave Ste 310, Arroyo Grande, CA 93420 | 2019-01-10 |
1629552815 | Leanne Marie Ford | Physician Assistant | 536 Camino Mercado, Arroyo Grande, CA 93420 | 2018-09-24 |
1730662107 | Kelli Thompson Hamma | Massage Therapist | 630 Lancaster Dr, Arroyo Grande, CA 93420 | 2018-09-12 |
1063962595 | Suzanne Erickson | Social Worker | 2820 Poquito Place, Arroyo Grande, CA 93420 | 2016-10-07 |
1255888459 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 2119 Lopez Dr, Arroyo Grande, CA 93420 | 2016-09-06 |
1225585664 | Tikva Treatment | Substance Abuse Rehabilitation Facility | 170 Nelson Street, Suite 102, Arroyo Grande, CA 93420 | 2016-09-01 |
1831541986 | Tikva Treatment LLC | Clinic/Center | 621 E Grande Ave, Arroyo Grande, CA 93420 | 2016-07-12 |
1255788543 | David E. Yocum, M.d., A Medical Corporation | Internal Medicine | 860 Oak Park Blvd., #204, Arroyo Grande, CA 93420 | 2016-05-17 |
1689059800 | David Hikaru Lindsey | Dentist | 203 Station Way, Arroyo Grande, CA 93420 | 2015-07-29 |
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Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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City | ARROYO GRANDE |
Zip Code | 93420 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.